I am writing in reference to an interaction that took place between a family and our nurse, Amie Marsh here in the IMCU. A patient was admitted with an extensive past medical history. This patient was being cared for in the step down unit where Amie was assigned as their nurse. As the patient’s hospital stay progressed and Amie got to know the patient and family, she had a conversation regarding advanced directives and final wishes. Mom had expressed that she understood her daughter had a rare mitochondrial disease that would shorten her life expectancy and that in the event of acute decompensation, she did not want the patient to be intubated or receive chest compressions. 

The day started for this patient no differently than others, and we had actually thought this patient was beginning to turn a corner. Mom thought that she would take advantage of this positive turn and make a trip home to shower and squeeze in some work from home. She thought that she would return to her daughter in the condition in which she left. However, God had different plans. The patient unexpectedly began to rapidly decompensate and required a change-of-shift escalation to the PICU. In the transition to a higher level of respiratory support, the patient suffered a respiratory arrest. The MD contacted mom to again confirm that she did not want compressions or intubation, to which she tearfully confirmed. It was at this point that resuscitation efforts were stopped and the patient passed. We were shocked and saddened by the result of such a quick turn of events. Mom was notified and was audibly hysterical over the phone and stated that she was en route to see her daughter.

Amie remembered an earlier conversation she and mom had. Mom expressed that one of her biggest fears was that her daughter would die alone. So when resuscitative measures were stopped, the monitor was turned off and Amie sat in peaceful silence with the patient and held her hand while she passed. This process took some time, but never did Amie leave her side. She quietly and respectfully prepared the patient for her family to say goodbye.

Amie then stayed well into the night shift so that she could be there when mom arrived, as she was the familiar face mom had gotten to know. The interaction that took place between these two, embracing tearfully in the hallway as Amie repeatedly ensured mom that her daughter was never alone, truly took my breath away. Amie gave that mom a sense of peace that she would have otherwise never gotten. She comforted her and let her know that her transition was painless, peaceful, and surrounded by love and compassion.

She stayed and visited the patient with mom and held her while she grieved the loss of her daughter. This interaction struck me to my core and made me think of how lucky nurses are to be so uniquely positioned to affect both patient and family experience during the most vulnerable times in a person’s life. It is truly an honor to gift a patient with a dignified death and to provide the most tender care to the family that is left behind to grieve the loss.

That night, standing in the ICU, Amie was the most beautiful example of what it means to be a nurse, and what it means to bear witness to the start of a new life and the end of another. She was a true comfort and blessing to this family who will undoubtedly be forever grateful to Amie and her affectionate care. I have never been prouder to work alongside people like Amie, but moreover, I have never been prouder to call her a friend. For this reason, I nominate Amie for the DAISY Award for Extraordinary Nurses.